Individual
THEODORE R NEUMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 E DOUGLAS RD STE 406, MISHAWAKA, IN 46545-1468
(574) 335-6580
Mailing address
59257 HIGH POINTE DR, SOUTH BEND, IN 46614-4114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01028195
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100325760
—
IN
Enumeration date
07/17/2006
Last updated
05/23/2023
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